title: The effect of 17α-hydroxyprogesterone caproate on preterm birth in women with an ultrasound-indicated cerclage.
abstract: We sought to determine if 17α-hydroxyprogesterone caproate (17P) reduces the rate of preterm birth (PTB) in women with an ultrasound-indicated cerclage (UIC). We retrospectively reviewed a cohort of women with a previous spontaneous PTB and current UIC placement for cervical length (CL) < 25 mm at < 23 (6)/ (7) weeks. The study group consisted of women treated with 17P; the control group consisted of women not treated with 17P. Primary outcome was spontaneous PTB < 35 weeks. Secondary outcomes included PTB < 32 weeks, PTB < 28 weeks, gestational age at delivery, and birth weight. A total of 58 women were identified; 15 (25.9%) received 17P, and 43 (74.1%) did not. 17P did not have a significant effect on PTB < 35 weeks (odds ratio 1.72, 95% confidence interval 0.50 to 5.89), nor did it have a significant effect on the secondary outcomes. Among women with a prior spontaneous PTB and current UIC for CL < 25 mm, 17P did not reduce the rate of PTB < 35 weeks.
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Jefferson Medical College of Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA. timothyrafael@hotmail.com
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Rafael
authors.forename: A Dhanya
authors.initials: AD
authors.lastname: Mackeen
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Berghella
mesh_terms: D000077713:17 alpha-Hydroxyprogesterone Caproate; D000328:Adult; D023802:Cerclage, Cervical; D002584:Cervix Uteri / Q000033:anatomy & histology / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D005865:Gestational Age; D006801:Humans; D006908:Hydroxyprogesterones / Q000627:therapeutic use*; D053208:Kaplan-Meier Estimate; D011247:Pregnancy; D047928:Premature Birth / Q000209:etiology / Q000517:prevention & control*; D011372:Progestins / Q000627:therapeutic use*; D012189:Retrospective Studies; D055502:Secondary Prevention; D014463:Ultrasonography; D002581:Uterine Cervical Incompetence / Q000000981:diagnostic imaging / Q000601:surgery
chemical_list: D006908:Hydroxyprogesterones; D011372:Progestins; D000077713:17 alpha-Hydroxyprogesterone Caproate